DLAM Zoonoses and Lab Animal Allergy training

1. DLAM Zoonoses and Lab Animal Allergy training

2. Purpose of Program • This training is intended for research animal handlers and animal caretakers who are consistently in physical contact with the animals in DLAM facilities. • These employees are required to participate in an annual occupational health surveillance program for animal handlers. • This training is required annually.

3. Possible Hazards in DLAM Facilities • Allergic responses • Animal bites, scratches, or other trauma • Zoonotic diseases

4. Animals and Health Risks LABORATORY ANIMAL ALLERGIES • 15% of the general population is allergic to animals. • 30 – 50% of those without a previous allergy history will develop an allergy to lab animals while working in that environment. • 10 – 15% of these allergic workers will develop asthma.

5. Risk Factors for Development of Laboratory Animal Allergies • Exposure to allergens • Duration • Frequency • Intensity • Previous allergic conditions • Personal history of allergies/atopy/eczema • Other predisposing conditions • Illness • Immunocompromised • Pets • Family history

6. Common Lab Animal Allergy Sources • Rats/ Mice--major allergens in urine/saliva • Cats--sebaceous glands, hair, saliva • Dogs--saliva, hair, skin • Rabbits--fur, saliva, urine • Birds--droppings • Bedding

7. Allergy Symptoms • Red, itchy, watery eyes, runny nose1 • Sneezing, itchy, runny nose, congestion1 • Red itching skin, welts, hives2 • Asthma3 – cough (can be late-phase with symptoms starting several hours after leaving the animal facility), wheezing, chest tightness, shortness of breath • Anaphylaxis4 – itching, hives, throat tightness, fainting, nausea, vomiting, diarrhea 1 = common, 2 = somewhat common, 3 = about 15 – 30%, 4 = rare

8. Prevention of Lab Animal Associated Allergies • Biosafety cabinets • Filter top cages • Ventilated cage racks • Biobubble • Choice of bedding • Reduce time with animals • Wash hands frequently • Animal density • Proper housekeeping practices • Proper humidity • Personal protective equipment (masks, respirator)

9. Treatment of Lab Animal Associated Allergies • Prevention is preferred • Education of employees • Proper use of personal protective equipment • Re-assign employees when needed • Medical treatment to reduce symptoms • If you develop allergy symptoms to lab animals, contact University Employee Occupational Health Clinic (UEOHC at 966-9119) for an appointment for a medical evaluation

10. Knowledge Review 1. Risk factors for developing laboratory animal allergies include: a. Amount of time spent around laboratory animals b. Family history of allergies c. Whether or not you have pets d. All of the above e. None of the above 2. Laboratory animal allergies can be prevented by using of which of the following? a. Good hygiene practices b. Biosafety Cabinets c. Respirators d. A & C e. All of the above

11. Zoonoses • Research personnel who handle animals and/or animal tissues are at risk for zoonoticdisease transmission. • Zoonoticagents are infectious agents capable of being transmitted from animals to humans or from humans to animals. (TB to monkeys, flu to people) • Zoonosescan cause minor or serious illness. In some cases, zoonotically infected individuals do not become ill. • On the other hand, some zoonoses can be extremely dangerous to people, especially those with a weakened immune system.

12. Zoonoses Bacteria • Exposure to feces/urine (e.g. Salmonella, Shigella, E. coli, Leptospira) • Bites/scratches: Bartonella(cat scratch disease), Rat Bite Fever-Spirillum minor, Streptobaccilismoniliformis, Leptospirosis Viruses • Herpes B virus from Macaques – potentially fatal to humans • Rabies virus – potentially fatal to humans • Lymphocytic Choriomeningitis Virus (LCMV)– rodents Parasites • Gastrointestinal – Giardiasis, cryptosporidium, tapeworms (in urine and feces) • Systemic – Toxoplasma (fatal defects in the fetus may occur if pregnant women are exposed to shedding cats) • Dermatomycosis(ringworm) can be spread by contact with infected animal Transmission of zoonotic diseases can be prevented by prompt recognition and isolation of any ill animal

13. Cats • Cat scratch disease--Bartonella henselae • Toxoplasmosis---Toxoplasma gondii • Prevention--good hygiene

14. Toxoplasmosis---Toxoplasma gondii • Toxoplasmosis is caused by the protozoan parasite Toxoplasma gondii. • Cats play an important role in the spread of toxoplasmosis. They become infected by eating infected rodents, birds, or other small animals. The parasite is then passed in the cat's feces in an oocyst form, which is microscopic. • Kittens and cats can shed millions of oocysts in their feces for as long as 3 weeks after infection. • A Toxoplasma-infected cat that is shedding the parasite in its feces contaminates the litter box or if allowed outside, can contaminate the soil or water in the environment as well.

15. Toxoplasmosis---Toxoplasma gondii • Toxoplasmosis is not passed from person-to-person, except in instances of mother-to-child (congenital) transmission and blood transfusion or organ transplantation. • People can be infected by: • Accidental ingestion of oocysts after cleaning a cat's litter box when the cat has shed Toxoplasma in its feces • Accidental ingestion of oocysts after touching or ingesting anything that has come into contact with a cat's feces that contain Toxoplasma • Drinking water contaminated with the Toxoplasma parasite

16. Toxoplasmosis---Toxoplasma gondii Pregnant Women • Mother-to-child (congenital) transmission • A woman who is newly infected with Toxoplasma during pregnancy can pass the infection to her unborn child (congenital infection). The woman may not have symptoms, but there can be severe consequences for the unborn child, such as diseases of the nervous system and eyes. If you are pregnant or thinking about becoming pregnant and you work with cats, please contact EHS for a risk assessment.

17. Sheep- Q Fever • Q fever is a zoonotic disease caused by the organism Coxiellaburnetii. • Individuals acquire this infection by inhaling aerosols and contaminated dusts generated by animals or animal products. Q fever can also be contracted via: • Direct or indirect contact with infected animal • Contact with contaminated surfaces, clothing, equipment, bedding, etc

18. Prior to working with or around sheep • PAPR respirators or N95 masks are required to enter the animal housing area and laboratory that contain sheep. • This requires annual training (EHS) and medical clearance and fit testing at UEOHC annually. • The following should contact UEOHC for a medical screening and/or EHS for a risk assessment : • Immunocompromised individuals and those with pre-existing heart valve conditions are at higher risk of infection and should be fully informed of the increased risks. • Pregnant women or women who are considering becoming pregnant should also be fully informed of the increased risks.

19. Swine • Infected swine can transmit diseases to humans via the fecal-oral route, urine or contaminated water splashes, or direct contact • Colibacteriosis (E. coli) • Salmonella (Non-typhoidal) • Leptospirosis • Ringworm

20. Rodents • Rat Bite Fever- Spirillum minor, Streptobaccilis moniliformis • Leptospirosis • Lymphocytic Choriomeningitis Virus (LCMV)

21. Parasites • Yersinia pestis--fleas from cats/ rodents in southwest • Borrelia burgdorferi (Lyme Disease)- transmitted to animals/humans by infected ticks

22. Non- Human Primates (NHP) Zoonotic hazards • Herpes B virus (Macaques) • Salmonella • Tuberculosis • Simian Immunodeficiency Syndrome (SIV), Simian T-Cell Lymphotropic Virus (STLV) • Endogenous retroviruses • Hepatitis A • Hepatitis B • Shigella dysenteriae

23. Rabies Virus • Feral animals represent the greatest risk • Acquire animals that have been documented free of disease • Post bite evaluation for need for Rabies booster, wound prophylaxis, tetanus

24. Herpes B Virus (Cercopithecine Herpesvirus 1) • Naturally occurring infection seen only in genus Macaca(rhesus, cynomolgus, pig-tailed, others). • 80-100% imported adult rhesus macaques are Herpes B positive. • In facilities where macaque monkeys are present saliva, genital secretions and conjunctival secretions are considered the primary body fluids associated with transmission • Transmission has been documented through handling infected CNS & kidney tissue • Feces, urine or other fluids may be contaminated • Human disease is rare and has been identified in about 50 cases and well-documented in 26 cases. • ~70% case fatality rate in humans

25. Tuberculosis • Transmitted to humans through exposure to infected animal/animal tissue. • Also a reverse zoonosis, can be spread from humans to primates • Screening is done by PPD in arm at UEOHC. • Positive tests indicate previous infection. • Chest x-rays are then required to rule out active disease.

26. Simian Immunodeficiency (SIV) • SIV is a lenti-virus that infects non-human primates in nature. Monkey SIV strains can infect humans, but does not lead to the development of AIDS. • Unlike HIV infections in humans, SIV infections in their natural hosts are widely believed to be non-pathogenic. However, if SIV is used to infect an Asian rhesus macaque, for example, the animal will develop an AIDS-like illness similar to HIV infection in humans

27. Hepatitis Viruses • Hepatitis A: • Enteric (oral/fecal spread) • Non chronic carrier state

28. Hepatitis Viruses • Hepatitis B • Bloodborne pathogen • Low mortality (1 % case fatality rate) • Up to 10% of those infected become chronic carriers with high incidence of cirrhosis and liver cancer. • Vaccine required (or declination)

29. Hepatitis Virus • Hepatitis C • Bloodborne. • Disease is milder in comparison with Hepatitis B, however there is a higher rate of chronic carriers. • No vaccine, however, treatment within weeks of infection can prevent chronic disease.

30. Routes of Exposure for Zoonotic Diseases Routes of Exposure • Bites and scratches from infected animals • Needlestick injuries with contaminated needles or scalpels • Eye and mucous membrane exposure to body fluids or particulates from infected animals

31. Percutaneous Exposure Zoonotic diseases are commonly spread percutaneously (bites, scratches, needlesticks): • Some organisms are Staphlyloccus aureus, Bartonella henselae • Proper wound care/ tetanus immunization • Appropriate antibiotic prophylaxis

32. Bacterial Infections from Bite Wounds • >200 species of bacteria in the mouths of many animals, including humans. • Streptococcal species, staphylococcal species, tetanus. • Bite wounds should be thoroughly cleaned. • Prophylaxis for moderate to deep bites with Amoxacillin/clavulinic acid (Augmentin).

33. Exposure Procedures • Immediate Response: • Mucous membrane: flush in an eye wash or potable water for a minimum of 15 minutes. • Non-intact skin exposures: Wash with soap and water or antiseptic for 15 minutes. REPORT ANY INJURIES AND ILLNESSES TO PI/LAB SUPERVISOR AND IMMEDIATELY REPORT TO UEOHC (962-9119)

34. Knowledge Review 3. Zoonotic agents are infectious agents capable of being transmitted from animals to humans only? a. True b. False 4. A vaccine for _____________ is available for DLAM employees who work with/around research animals. a. Hepatitis B b. Hepatitis C c. Herpes B d. All of the above 5. Zoonotic diseases cannot be spread by: a. Needlesticks with contaminated needles b. Contaminated materials being splashed into the eyes c. Contaminated materials coming into contact with gloved hands d. Being bitten by an infected animal

35. Access Control and Staff Training • Training (more extensive & periodic) • Personnel must enroll in medical surveillance program • Restricted/controlled access • Written emergency response plans

36. Hazardous Agents Used in Research Animals • Animals exposed to biological, radiological, or chemical hazards can create a risk of exposure to people. • When working with animals that have been exposed to hazardous agents, precautionary measures (use of PPE, engineering and administrative controls) should be taken. • Read the Use of Biological, Chemical, Radiation forms posted on the animal room/cubicle doors

37. Minimize Risk • Wear proper PPE (respirators, gloves, Tyvek suit, gown, shoe covers, etc.) as indicated by signage. • Use gloves when handling animals & change gloves between animals. • Wash your hands as soon as possible after removing gloves. • No eating, drinking, smoking, applying cosmetics or handling contact lenses in any DLAM facility.

38. Minimize Risk • Keep food intended for human consumption separate from animal food. • Report any animals that appear to be ill. • Report any occupational illness or injury to your lab manager and/or PI and immediately report to UEOHC (919-966-9119, M-F 8:30-4:30)

39. Immunocompromised/Pregnant Individuals • Immunocompromised individuals and pregnant women should be aware of the potential zoonotic hazards that may be present in the workplace. • If you are undergoing chemotherapy/radiation therapy, being treated with steroids or other drugs that could cause immunosuppression and/or you are pregnant or plan on becoming pregnant, please notify EHS to determine appropriate protective measures and monitoring.